The bill merely requires that actions be done in “accordance” with its provisions. This renders ALL patient protections (safeguards) unenforceable.

Dear Members of the Committee:

I am a lawyer in Washington State, where assisted suicide is legal. Our law is based on a similar law in Oregon. Both laws are similar to SB 261.

SB 261 sets forth patient protections in sections 3 through 26.1 The bill also repeatedly says that actions are to be done in “accordance” with sections 3 through 26.2 For example, the bill states:

Death resulting from a patient self-administering a controlled substance that is designed to end his or her life in accordance with the provisions of sections 3 to 26, inclusive, of this act does not constitute suicide or homicide. (Emphasis added).3

The bill does not define “accordance.”4 Dictionary definitions include “in the spirit of,” meaning in thought or intention.5 A mere thought to comply with patient protections is good enough. Actual compliance is not required. More to the point, this situation renders all bill protections (“safeguards”) unenforceable. For this reason alone, the bill must be rejected.

Disability rights activists from across the state will rally as the New York Court of Appeals hears oral arguments Tuesday afternoon, May 30th in the Myers v. Schneiderman assisted suicide case.

Not Dead Yet led the filing of a Disability Rights friend-of-the-court brief in the Court of Appeals in support of the New York State Attorney General, and earlier rulings in the case by the Supreme Court and Appellate Division, both of which dismissed a case seeking to legalize physician assisted suicide.

Joining in the Not Dead Yet brief were ten other national and New York state disability rights organizations: ADAPT, the Autistic Self Advocacy Network, the Center for Disability Rights, the Disability Rights Center, the Disability Rights Education & Defense Fund (DREDF), the National Council on Independent Living, the New York Association on Independent Living, Regional Center for Independent Living and United Spinal Association, collectively referred to as the “Disability Rights Amici.”

New York attorney Adam Prizio handled the filing on behalf of the disability organizations. “Our basic position is that when some people get suicide prevention while other people get suicide assistance, and the difference is the person’s age, disability or health status, that’s unlawful discrimination,” said Prizio. “It’s a problem that certain people are being told that others not only agree with their suicide, which is bad enough, but will even help them carry it out. It’s a deadly form of discrimination and, as our brief says, it violates the Americans with Disabilities Act.”

Marilyn Golden, senior policy analyst with DREDF, summarizes concerns about a government authorized, medically administered public policy of assisted suicide as follows:

“If assisted suicide is legalized, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.”

Disability advocates are often criticized by assisted suicide proponents who claim that assisted suicide is only for the terminally ill, not people with disabilities. Activists will distribute information which refutes that claim based on data from Oregon, where it is legal.

The brief also expresses concerns about the context of health care cost-cutting in which assisted suicide is being advocated. “Elders and people with disabilities too often face economic or other pressures to get out of the way,” said Diane Coleman, president/CEO of Not Dead Yet.

“If assisted suicide becomes an accepted practice, coverage may be denied for more expensive healthcare, as we’ve already seen in Oregon and California. What is being promoted as a ‘right to die’ could very quickly become an expectation, even a duty to die in this climate.”

The research indicated that assisted deaths, that are done "outside of the law" share a high co-relation with the demographic group of people who are over the age of 80, who are incompetent to make decisions, who usually die in a hospital and usually have an unpredictable end-of-life trajectory, representing a vulnerable patient group at risk of having euthanasia imposed upon them.

Uncontrolled, clandestine euthanasia practices to help the terminally ill to die could be avoided if New Zealand legislated to control physician assisted dying, a Belgian medical expert says.

Professor Jan Bernheim​, an oncologist and founder of 'Not Necessarily Terminal', addressed a meeting in New Plymouth on Monday night attended by around 40 people.

New Plymouth was the second of eight meetings he will talk at during the next three weeks as a guest of the Voluntary Euthanasia Society for a series of nationwide public talks entitled 'Dying Well in Belgium'.

"In Belgium we've put an end to the clandestine practice, and because of the openness of the whole process, abuse of the dying patient is much less probable now that it is legalized with strict controls and peer review in place."

The law also protected caregivers from undue prosecution.

Before the law changed in Belgium, dying patients who requested euthanasia with the knowledge of their families or nursing staff were less likely to get it because doctors were worried they could be charged with murder if someone who knew about the request objected to euthanasia, he said.

Ironically, before the law, dying patients with intractable suffering who did not request euthanasia were more likely to get their suffering shortened paternalistically by doctors.

Many media outlets are promoting the message that euthanasia and assisted suicide are being legalized everywhere and yet the reality proves that the opposite is true.

On Tuesday May 23 the Maine House defeated assisted suicide bill L.D. 347 in a bipartisan 85-61 vote and on Wednesday May 24 the Tasmanian parliament defeated euthanasia bill (Voluntary Assisted Dying Bill) by a vote of 16-8.

The bipartisan 85-61 vote against the bill followed lengthy and oftentimes emotional debate among lawmakers sharing personal stories of watching loved ones battle terminal diseases. The so-called “death with dignity” bill had passed the Maine Senate by a single vote last week but faced a potential veto from Gov. Paul LePage even if it had passed the House.

“My conscience tells me that this is the wrong direction for a variety of reasons,” said Rep. Gay Grant, D-Gardiner. “This is not a partisan issue. It is a human issue.”

In debate, Michael Ferguson MP criticised the euphemistic language of the bill, arguing that such a grave matter demands clarity:

“We all agree it is a matter of life and death and if we cannot strip away the euphemistic language and discuss the reality of the matter then it will not be an honest debate and the public interest would not be served.

“I ask those promoting this bill to be truly frank and honest in their descriptions, and for those listening to the debate today, if or when you hear those euphemisms, you need to remind yourself that the real words, however distasteful they are, are mercy killing and assisted suicide by a doctor.”

Many people will say, but Alex, that is only two jurisdictions. The fact is that in 2017 assisted suicide bills have been stopped or defeated in Hawaii, Utah, New Mexico, Nebraska, Minnesota, and Maryland while in several other states, assisted suicide bills were introduced but lacked support to even be debated.

This is an issue that is literally about life and death.Legalizing euthanasia or assisted suicide gives physicians the right in law to kill their patients.

The euthanasia movement fear mongers its agenda as a means of preventing an agonizing death in pain that cannot be controlled. It’s all a false pitch. That’s not why it’s actually done.

Rather, existential anguish drives people to seek doctor-administered or prescribed termination. That has been experience in Oregon. Now too, Canada. From a study published in the New England Journal of Medicine;

Those who received MAiD [medical aid in dying] tended to be white and relatively affluent and indicated that loss of autonomy was the primary reason for their request.

Other common reasons included the wish to avoid burdening others or losing dignity and the intolerability of not being able to enjoy one’s life.

Few patients cited inadequate control of pain or other symptoms.

These are important issues that need to be addressed through vigorous suicide prevention and other mental health interventions.

But they are not provided. Instead, the desire to die for fear of being a burden or losing autonomy is validated with the lethal jab or the poison pills. And then, that type of death is pushed toward normalization.

Not providing vigorous interventions for existential anguish is like depriving a cancer patient of morphine, and then helping her die because she is in so much pain.

Wednesday, May 24, 2017

Rutland, Vt. – A pro-suicide group has dropped its appeal of a federal court’s decision which affirmed that a Vermont law can’t be interpreted to require pro-life health professionals to counsel or refer patients for assisted suicide. As a result, the U.S. Court of Appeals for the 2nd Circuit officially dismissed the appeal Monday, thus ending the case.

The withdrawal of the appeal by Compassion & Choices leaves in place a consent agreement between physician groups and the Vermont Attorney General’s office, which agreed that the court was correct in deciding that the state’s Act 39 does not force conscientious professionals to ensure all “terminal” patients are informed about the availability of doctor-prescribed death.

“Vermont health care workers just want to act consistently with their reasonable and time-honored convictions without fear of government punishment,” said ADF Senior Counsel Steven H Aden, who argued before the U.S. District Court for the District of Vermont in November of last year in Vermont Alliance for Ethical Healthcare v. Hoser. “Conscientious Vermont healthcare professionals are in agreement with the state that the law doesn’t force them to participate in this heinous process, and they are pleased that the nation’s foremost advocate of assisted suicide, Compassion & Choices, has abandoned its effort to force them to do so.”

Alliance Defending Freedom attorneys and ADF-allied attorney Michael Tierney represent the Vermont Alliance for Ethical Healthcare and the Christian Medical and Dental Association, groups of medical professionals who wish to abide by their oath to “do no harm.”

Act 39, Vermont’s assisted suicide bill, passed with a very limited protection for attending physicians who don’t wish to dispense death-inducing drugs themselves, but state medical licensing authorities construed a separate, existing mandate to counsel and refer for “all options” for palliative care to include a mandate that all patients hear about the “option” of assisted suicide. For that reason, the groups representing pro-life health professionals filed suit.

The court ruled that the groups lacked a legal right to bring the lawsuit because the law actually doesn’t force them to act contrary to their conscience—a finding that Compassion & Choices initially opposed. The dismissal of the appeal leaves Vermont healthcare professionals free to “do no harm” without fear of retaliation for their pro-life views.

Alliance Defending Freedom is an alliance-building, non-profit legal organization that advocates for the right of people to freely live out their faith.

Tuesday, May 23, 2017

The euthanasia debate is on the front-burner in Australia, especially in the states of Victoria and Tasmania. In one of the latest salvos, ethicist Professor Margaret Somerville claimed that suicide rates rise in jurisdictions where euthanasia and assisted suicide are legal. This prompted a blast from Neil Francis, a former President of the World Federation of Right To Die Societies and a leading campaigner for euthanasia in Australia. This is Professor Somerville’s response.

B

Margaret Somerville

y Margaret Somerville

Neil Francis is correct in criticizing me for a loose statement that "the general suicide rate has increased in every jurisdiction that has legalized assisted suicide."

Although I believe that my statement will prove to be correct, at this point in time I should have left out the word "every."

One problem in obtaining the required evidence, is that it’s difficult if not impossible to know how often physician-assisted suicide or euthanasia (PAS-E) is being used in countries where those interventions are legal to commit what we should view as “ordinary suicide”–if one can ever regard suicide as “ordinary”, but for want of a better term.

“Suicide by police”–a suicidal person engages in conduct with the intention that the police will respond by shooting them - is a recognized phenomenon. Now we can consider “suicide by physician”.

Two features of legalized PAS-E make “suicide by physician” seem likely: The percentage of deaths occurring from PAS-E, for instance, in The Netherlands and Belgium, is rising by approximately 10 per cent each year and is now around 4 percent of all deaths. And the conditions for access to PAS-E are expanding in both jurisdictions. If one is not terminally or physically ill, neither of which is a legal requirement in either country, is euthanasia “ordinary suicide”? And what about if a person wants PAS-E because they are just “tired of life” or feel they have a completed life as the Netherlands is now contemplating allowing or, as an elderly couple proposed on ABC’s Q&A, simply want to avoid going into a nursing home, should these be classified as “ordinary suicide” cases?

Dutch Professor Dr. Theo Boer, a former member of one of Holland’s five Euthanasia Regional Review Committees (2005-2014) has undertaken a study which will be published shortly which, in his words, shows

Theo Boer

the assumption that euthanasia will lead to lower suicide rates finds no support in the numbers. The percentage of euthanasia deaths of the total mortality rate tripled from 1.3% in 2002 to 4.08% in 2016. During that same period, the suicide numbers did not go down: From being 1,567 in 2002, they went up to 1,871 in 2015, a rise of 19.4%. The suicide rates reached a relative low of 1,353 in 2007, compared to which the 2015 numbers constitute a rise of 38.3%. This is even more significant given the fact that from 2007 on euthanasia started becoming available to people with chronic diseases–psychiatric diseases, dementia, and others. In terms of the percentage of the overall mortality of suicide deaths, the numbers went up from 1.01% in 2007 to 1.27% in 2015.

…For the sake of comparison, I have looked at the suicide rates of some countries which are close to the Netherlands in terms of ethnicity, age, religion, and language but which, with the exception of Belgium, lack the option of euthanasia. If the suicide numbers in the Netherlands have gone up, one would expect, at least a similar increase in the suicide numbers would occur in countries without the option of euthanasia. However,…the Netherlands of all countries show the biggest increase in the suicide numbers.”

Mr. Francis dismisses researchers David Jones' and David Paton’s report on suicide data in Oregon on which I relied to show a rise in the state’s suicide rates on the basis that it was “published in a minor journal”, the Southern Medical Journal. This claim is specious, even if it were a “minor journal”. For the record, it is a peer-reviewed medical journal indexed and abstracted in Index Medicus, Current Contents, Science Citation Index, and EMBASE which has published over 45,000 articles. I leave it to others to decide its status.

Moreover, if Mr. Francis’ claim as to its status were correct and if Jones’ and Paton’s article were, as Mr. Francis describes it, “a wobbly econometric modelling study”, it stands to reason that the journal would be more accessible in terms of publishing rebuttals or questions about the article. To date, to my knowledge, no one has done so, not there, not anywhere.

[W]e found that legalizing PAS was associated with a 6.3% (95% confidence interval 2.70%–9.9%) increase in total suicides (including assisted suicides). This effect was larger in the individuals older than 65 years (14.5%, CI 6.4%–22.7%). Introduction of PAS was neither associated with a reduction in nonassisted suicide rates nor with an increase in the mean age of nonassisted suicide. (Emphasis added)

Conclusions: Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides.

As Jones and Patton recall, pundits claimed at the time of the public debate in Oregon about legalizing physician-assisted suicide that having access to assisted suicide would reduce “nonassisted” or “ordinary suicide”, which it clearly did not. This is something Australian legislators should note.

I will just mention California, which has very recently legalized physician-assisted suicide. There was concern that people who were involuntarily hospitalized because they were mentally ill and “dangerous to themselves (they were suicidal) or others” could not have access to physician-assisted suicide. This has now been “remedied” and a special process established to allow them to apply to have physician assistance in killing themselves.

Monday, May 22, 2017

Ontario, Canada has passed a law formally legalizing lethal injection euthanasia. And it will force all provincial doctors to be complicit by either doing the deed themselves to all legally qualified patients who request to be killed, or by tasking them with procuring a death doctor. From the Ontario Ministry of Health and Long-Term Care Website (my emphasis):

In Ontario, health regulatory colleges are responsible for regulating their respective professions in the public interest. In doing so, colleges may establish policies and standards that their members must comply with, including policies and standards regarding medical assistance in dying.

The College of Physicians and Surgeons of Ontario requires that when physicians are unwilling to provide certain elements of care for reasons of conscience or religion, an effective referral to another health-care provider must be provided to the patient. An effective referral means “a referral made in good faith, to a non-objecting, available, and accessible physician, other health-care professional, or agency”.

Think about this. Three years ago, it would have been a felony for doctors to kill patients, potentially landing them in prison.

Now, refusing to participate in homicide could cost them their medical licenses.

The question I am often asked is, “Why?” Why force a doctor to participate in killing against her moral or religious beliefs when a patient wanting to be lethally injected could easily find a death doctor through a pro-euthanasia organization or a list of willing MDs published by the government–as has been established in other provinces.

Here’s what I think:

First, a doctor refusing to kill sends a powerful message that the act is wrong morally and medically. That message must be silenced.

Second, medicine is being weaponized as a means of turning culture away from the core principles of intrinsic human dignity and the equality/sanctity of life, into a society more focused on radical and atomistic individualism and utilitarian outcomes.

Fourth, this is a splendid way to cleanse orthodox religious believers, Hippocratic Oath-accepting doctors, and pro-lifers from the health professions–and dissuade those holding such beliefs from becoming physicians, nurses, and pharmacists.

I am sure there are other forces at work. But this much I know: Conscripting doctors to be homicide facilitators as a condition of practicing medicine is tyranny.

Many Ontario doctors and nurses working in palliative care say their objection to playing a role in assisted suicides may force them to leave the medical profession.

Many physicians "don’t want to make a referral that would result in the death of a patient,”

Dr. Kulvinder Gill said, adding forcing medical workers to participate strips them of their conscience rights under the Canadian Charter of Rights and Freedoms. “Access (to assist dying) must not depend on a physician having a role.”

Dr Kulvinder Gill (centre)

Dozens of medical professionals attended the press conference. The Toronto Sun article quoted some of the medical professionals as stating:

Dr. Jane Dobson said she is at a crossroads because she won’t make referrals for assisted dying.

“There are palliative-care providers who will be forced to leave (the profession) because of the conscience,” Dobson said.

Pharmacist James Brown says he believes drugs should be used to treat diseases — not kill someone.

“They’re never intended to take a patient’s life. Knowing a medication is meant to take a life goes against my core values,” Brown said.

Doctors, nurses and other medical professionals must never be forced to be complicit in acts of killing their patients.

The Victorian Ministerial Advisory Panel charged by Premier Daniel Andrews with the task of developing a safe way to kill people and to help them to suicide, released its interim report yesterday.

Set up in December last year the 'expert panel' has conducted state-wide hearings and accepted submissions on precisely how to make a safe law.

The Panel's introductory discussion paper made it perfectly clear that their job was not to consider the ethical/moral concerns: "The purpose of this consultation is to ensure that parliament may debate the merits of voluntary assisted dying through well-informed and workable legislation."

How that outcome could be considered as 'values-neutral' is beyond comprehension. Any proposition that has supposedly been vetted and designed through what I am sure will be described as a 'lengthy and thorough process' would seem to have the 'tick of approval'. The 'merit' is loaded into the outcome as Health Minister, Jill Hennessy confirmed today:

“We have the very best medical and legal experts working on this to make sure that when the time comes, everyone in the Victorian parliament has the information, and assurances they need to make an informed decision about this important issue.”

In the 64 pages and in 29,143 words, the interim report uses the word euthanasia only once - and that in a quotation from a submission. Assisted Suicide is mentioned three times - again, only from quotations and suicide (separately); well, that's where matters become more interesting again.

"Some denominational submissions suggested it should not be called ‘voluntary assisted dying’ because it would obscure the role of medical practitioners in aiding suicide."

Why the mention of 'denominational'? In all of the quotes from various submissions and testimony, no mention is made about the name of the individual or organisation (given only a number), what is it about this reference that requires an identifier? It is difficult to come to any other conclusion than to observe that by the use of 'denominational' the report seeks to dismiss the concerns as being a 'religious objection' only.

The very next sentence amplifies the subterfuge:

"An alternative view was expressed that the language of suicide should not be conflated with voluntary assisted dying because of the person’s proximity to death due to illness."

Who expressed that view? Suicide is suicide; no amount of qualification changes that. But here's where the euphemism becomes really useful: Read the quote again and substitute 'suicide' for 'voluntary assisted dying' and the reasons for its use become clear. This is double-speak.

If any more proof was needed, the next occasion that the 'S' word appears is in the context of a discussion about record keeping and monitoring:

"It was noted that if information about those whose request was denied was linked to other data such as suicides, it would provide a greater understanding of how the framework was operating."

So, if a person gets access to the law, then it's 'voluntary assisted dying'; if they fail to qualify for some reason and end their life by other means it can be called suicide. The premise here, of course, is that 'assisted dying' will reduce the incidence of other forms of suicide. This has proven not to be the case in Oregon and any expectation that it might be the case in Victoria is supposition at best.

There's more! In a discussion about legal liability it is noted that, 'acting outside the proposed legislation, such as aiding and abetting suicide, would still be a criminal offence.'

Indeed. The death might be by precisely the same method under precisely the same conditions - even with full consent - yet if one condition identified in the law is not met, then it is assisted suicide! You couldn't make this stuff up!

But the final mention of 'suicide' is really where obfuscation and euphemisms are so blatantly evident:

"Life insurance

"The impact of the listed cause of death on insurance eligibility was also highlighted in forums and submissions. It was noted that there should be no loss of insurance benefits as a result of exclusion clauses for suicide. This was one of the reasons many considered that voluntary assisted dying should not be listed on a death certificate. Others were of the view that it was clearly the underlying terminal illness or disease that was the cause of death so there should be no issues with insurance."

Like many other bills we've seen in Australia, this proposition would legislate further obfuscation and would make liars out of doctors by forcing them to falsify the cause of death. Insurance industry bodies have railed against this kind of inclusion previously and for good reason. They raised the same concerns in The Australian today. It opens up the possibility of someone signing up for a life insurance policy only months before their suicide for the benefit of their estate with a minimum of paid premiums. Think of the possibilities of 'inheritance impatience', otherwise known as Elder Abuse.

Further obfuscation came via Victorian Greens MLC, Colleen Hartland in the same article:

“It is the issue around ­insurance, and the reality is that the cancer or the neurological disease is what killed them, they have just allowed to die a bit ­earlier,” she said.

What kind of policy outcome are Victorians likely to gain from all of this if their elected representatives and appointed officials can't get past the fabricated expressions of the death dealing lobby?

Buddha is often quoted as having said that, "Three things cannot be long hidden: the sun, the moon and the truth." He never visited Victoria.

Sunday, May 14, 2017

In 2017, theassisted suicide lobby has lost in every US state where they have introduced assisted suicide legislation. Recently, Nevada Governor Brian Sandoval stated that he opposes Senate Bill 261, a bill that would legalize assisted suicide in Nevada ensuring that the bill will die.

The Senate Health and Human Services Committee took no immediate action on the (assisted suicide) measure, which faces an uphill battle. Gov. Brian Sandoval does not support the policy, spokeswoman Mari St. Martin said on Wednesday.

Wednesday, May 10, 2017

The Hippocratic Oath reads in part, “I will give no deadly medicine to any one if asked, nor suggest any such counsel.”

But Canadian death doctors and nurse practitioners who euthanize the sick, disabled, and mentally ill–soon perhaps, also those with Alzheimer’s–are actively embracing the very lethal act Hippocratic doctors forswore for the protection of vulnerable patients.

How “in” to euthanasia are they? They have formed an association of euthanasia providers–killers, because that is what euthanasia is, killing–called CAMAP, the Canadian Association of MAiD Assessors and Providers. (MAID stands for “medical assistance in dying.”) The organization’s purpose:

While we are predominantly an association of physicians and nurse practitioners, anyone interested in supporting this work is most welcome to join our community and become an associate CAMAP member.

This includes nurses, pharmacists, speech & language specialists, administrators, law makers, lawyers, social workers, activists, counsellors and more. Already underway are plans for a National Conference on MAiD in June 2017 in beautiful Victoria, BC, development of an advisory board, plans for a mentorship program and a newsletter with cross-country information and case reviews.

Membership provides you with a reduced rate for registration at our conferences, access to our newsletter, general MAiD news updates, case reviews and an opportunity to join with a passionate and compassionate group of physicians and nurse practitioners doing this vital work.

They
had plenty of ethics. It was just the wrong kind - See more at:
https://www.mercatornet.com/features/view/19727#sthash.oTesqVGv.dpuf

They
had plenty of ethics. It was just the wrong kind - See more at:
https://www.mercatornet.com/features/view/19727#sthash.oTesqVGv.dpuf

Physician Karl Brandt (center)

By Michael Cook

German medicine under Hitler resulted in so many horrors – eugenics, human experimentation, forced sterilization, involuntary euthanasia, mass murder – that there is a temptation to say that “Nazi doctors had no ethics.”

However, according to an article in the Annals of Internal Medicine by Florian Bruns and Tessa Chelouche (from Germany and Israel, respectively), this was not the case at all.

In fact, medical ethics was an important part of the curriculum for German medical students between 1939 and 1945. Nazi officials established lectureships in every medical school in Germany for a subject called “Medical Law and Professional Studies” (MLPS).

There was no lack of ethics. It was just the wrong kind of ethics.

The focus of the scholars’ study is Rudolf Ramm, a German general practitioner who became the pre-eminent purveyor of Nazi medical ethics during the War years. He was an ardent anti-Semite who demanded a “complete solution to the Jewish Question in Europe” and a “radical elimination of the Jews.”

Ramm was editor-in-chief of the journal of the German Medical Association, Deutsches Ärzteblatt, and published a textbook, Ärztliche Rechts- Standeskunde (Medical Law and Health). The textbook sold out within a year.

Ramm did not survive to be a defendant in the famous “doctors trial” in 1947. He was tried and shot by the Soviets in August 1945. His book was banned a few months later.

What did medical students learn during the Nazi era? According to Bruns and Chelouche, it was “the unequal worth of human beings, the moral imperative of preserving a pure Aryan people, the authoritarian role of the physician, the individual’s obligation to stay healthy, and the priority of public health over individual-patient care.”

However repugnant this now sounds, Ramm believed that the Nazi ideology was responsible for the “reinstatement of a high level of professional ethics.” He was delighted that “the profession had been extensively cleansed of politically unreliable elements foreign to our race” (that is, German-Jewish physicians).

Bruns and Chelouche sum up the pillars of his ethics as follows:

Ramm saw 3 distinct dangers facing the German people: “racial miscegenation,” a declining birthrate, and the “growth of inferior elements” in the German population. He traced the origins of these perceived dangers to a “disregard for the laws of nature,” caused by church dogma and socialist ideologies. Ramm denounced any form of health care for “hereditarily inferior” people and asserted that every person in Nazi Germany had a moral duty to stay healthy.

With the benefit of hindsight, it is easy to see Nazi “medical ethics” for what they are: a flimsy rationalisation to allow physicians to participate in imposing the rule of the Third Reich upon Europe. Their collaboration with the regime was shameful, to say nothing of the horrors of experimentation on unwilling prisoners and mass extermination.

But Bruns and Chelouche are less interested in raking over the coals than in drawing lessons for today’s doctors. Doctors must resist the temptation to believe that they are much more ethical than in “the bad old days,” they observe. Ethical standards do not always progress; sometimes they can regress.

In fact, in the Weimar Republic, ethical standards for human experimentation were “remarkably advanced,” they write. In 1931 the government had responded to scandals in medical practice by setting down clear guidelines. In some respects, they were even stricter than the Nuremberg Code of medical ethics which was adopted after World War II. Non-therapeutic research was “under no circumstances permissible without consent,” a cost-benefit analysis and animal experimentation were required to minimize the risk to humans; publication of results had to respect human dignity, and so on.

So the Nazi doctors could hardly plead ignorance of humane ethical standards. In fact, the authorities did not even bother to repeal the Weimar legislation. They simply redefined the subject of experimentation to exclude concentration camp inmates.

Bruns and Chelouche conclude with this warning:

It is important to realize that ethical reasoning can be corrupted and that teaching ethics is, in itself, no guarantee of the moral integrity of physicians. The history of bioethics reveals that the professional ethos of physicians is more fragile than we might believe because it depends on the moral zeitgeist and politico-social circumstances, both of which are subject to change …

Today’s danger is imposing extreme individualism upon medical practice so that ethics is defined by the single standard of autonomy. As long as a patient acts “autonomously,” with informed consent, anything goes: from abortion, to self-mutilating surgery, to euthanasia.

And in the name of this ideology, every kind of injustice can be rationalised. Today, as in Nazi Germany, the medical profession is in danger of being purged of “politically unreliable elements” – conscientious objectors.

But autonomy is only one dimension of human well-being. It is compatible with loneliness, unhappiness, physical suffering, cruelty, and anti-social behaviour – as Belgium, the Netherlands and Canada are discovering while legal euthanasia expands its reach.

In many cases, today’s medical ethicists looking for examples of corrupt ethical reasoning need not google for images of Rudolf Ramm; they can simply take a selfie.

Michael Cook is editor of MercatorNet. This appeared at mercatornet.com and is reposted with permission.

77% of submissions to
Parliament’s Health Select Committee are opposed to
changing the law on assisted suicide and euthanasia, an
analysis found.

“The Voluntary Euthanasia Society touted that ‘the Health Select Committee received a record 21,533 submissions on the issue, indicating intense public interest in a potential law change’, says Renée Joubert, executive officer of Euthanasia-Free NZ. “By their own logic, the results of this analysis demonstrate an overwhelming opposition to a law change.”

“When New Zealanders are given the opportunity to engage with the issue, as opposed to merely responding to a single poll question, most support the current legislation. This is certainly our experience when interacting with people all over the country.

“The public are understandably concerned that the legalisation of assisted suicide and voluntary euthanasia poses risks to vulnerable people, which is why advocates propose safeguards. However, these safeguards are unenforceable in practice.

“Polls often elicit a knee-jerk reaction, especially when the questions are emotive or leading, such as referring to a painful condition. In reality nowadays, terminally ill Kiwis do not need to die in pain. A poll question about euthanasia for pain is inappropriate.

“As the authors of the January 2017 NZMJ study admitted, “the item in our study included the terms ‘painful’, ‘incurable disease’ and ‘request’, which may have influenced participants to express increased support for euthanasia’.”

The Care Alliance analysed 21,277 submissions, excluding duplicates and a small number that could not be coded. An independent research company reviewed a sample of the coded submissions and concluded “with at least 95% confidence that the overall classification percentages are accurate within no more than 0.4% variation”.

The results of the full analysis shatter assumptions about public attitudes to euthanasia and assisted suicide.

• The assumption that the high number of submissions demonstrate overwhelming support for a law change:

The analysis found that 77.1 % of submissions (16,411) were opposed to a law change, 19.5 % (4,142) were in favour, and 3.4 % (724) were neutral or unclear on this issue.

• The assumption that support of legalisation is secular and opposition to legalisation is based on religious beliefs:

63.6 % of submissions (13,539) oppose a law change and also make no reference to religion. Only 18.5% of submissions (3,934) support a law change and also make no reference to religion.

There are religiously motivated people on both sides of the debate. 14.8 % of submissions included religious arguments. The majority of these (13.5% of the total) oppose a law change, and 208 submissions (0.93% of the total) support a law change.

• The assumption that submissions opposing a law change are mostly one-liners:

About 44% of submissions in opposition are between two lines and a page. Even if submissions of a certain length were to be discounted, the submissions opposing a law change would still outnumber those supporting a law change in other length categories.

The Health Select Committee conducted an investigation into ending one’s life in New Zealand, in response to a petition by former MP Hon Maryan Street and 8,974 others in June 2015 requesting Parliament to “investigate fully public attitudes towards the introduction of legislation which would permit medically-assisted dying in the event of a terminal illness or an irreversible condition which makes life unbearable”.

After extensive media coverage about the investigation, especially during January 2016, the Committee processed 21,435 written submissions, a record number of unique submissions received on any issue to date. These, and subsequent supplementary submissions, are published on Parliament’s website.

In August 2016 Dr Jane Silloway Smith analysed a random sample of these submissions and found that 78% were opposed to changing the law while 22% were in favour. The 16000voices.org.nz campaign was launched to highlight some submissions in video and written form.

Friday, May 5, 2017

Anyone looking at the experience in Canada since euthanasia and assisted suicide laws came into force last year, should be struck by the moves to extend the law so soon after they had been passed. After all, when you look to Belgium and Holland and even Oregon USA, the moves to expand their laws and/or the application of their laws has taken some time to develop.

There are many reasons why the European and Oregon situations have taken time to see the various incremental legal and effective interpretational changes gather momentum. In Belgium and Holland the statutes were written in very broad terms relating to unbearable and irretrievable suffering. While the understanding at the time of their debates focussed on euthanasia as a 'last resort' option for people in the last stages of a terminal illness, the wording never restricted application in that way.

In the last five years and more there has been a continual pushing at the edges of the community understanding of the breadth of the law. Euthanasia for tinnitus, for blindness, for psychological suffering, for the accrual of minor complaints associated with old age, for fear of entering a nursing home - all unthinkable in the beginning. Add to that the 2013 statute amendment to include children in Belgium and the current discussion in Holland in respect to assisted suicide for people over 70 years of age who are simply 'tired of life', and one can legitimately wonder where it will all stop.

As Dutch journalist, Gerbert van Loenen once observed:

“Making euthanasia and physician-assisted suicide legal started a development we did not foresee. The old limit ‘thou shalt not kill’ was abandoned, a new limit is yet to be found.”

Canada seems bent on catching up with the Benelux countries at some pace.

In Victoria, Australia, there also seems to be something of a rush.

A Ministerial Advisory Panel charged with the role of consulting about how to make assisted suicide safe, is due to provide an interim report to Premier Daniel Andrews any day now. The final report is due in July and legislation is slated for the second half of this year.

Recommendation 49 of that report called upon the Victorian Parliament to legislate assisted suicide for people, “suffering from a serious and incurable condition which is causing enduring and unbearable suffering” and that these persons must be “at the end of life (final weeks or months of life)”.

So, not necessarily but most likely a terminal illness but still only for those at the very end or, as the Dutch talked about: a 'last resort' option.

Politically this makes sense. The game, if I can call it that, is to gain 50% plus one support in the two chambers of parliament. The logic is, of course, that it is the first hurdle that is the hardest. Better to get something on the statute books rather than risking yet another loss from trying for too much.

“Politicians need to ask themselves: is it about being pure or is it about saying ‘let’s get the best result we can’?”

This warning did not stop Victorian euthanasia supporter, Dr Rodney Syme from entering the debate immediately arguing for an expansion of eligibility to include "neurological failure, such as multiple sclerosis, motor neurone disease and Parkinson's disease, who have progressive diseases, and those with profound stroke or high quadriplegia who have a static condition, may have an ill-defined trajectory to death, and while suffering unbearably, may be discriminated against by narrow legislation." It is precisely the same sort of argument that could (and will) be made for a later amendment if Syme does not get his way. Think about that.

Indeed, everyone knows that later extension is a possibility via an amendment bill. Euthanasia for children was originally considered for the first Belgian debate. Trudo Lemmens relates that, ‘children were explicitly excluded from the ambit of the original law because “it was deemed so controversial that including it may have threatened approval of the Euthanasia Bill.”’

But the advisory panel wants to extend the timeline and the government is believed to be considering three options: 24 months, 12 months or six months.

It is mere speculation on my part, but it would seem that this kind of qualifier might be a compromise position between the Parliamentary Inquiry's recommendation and the agitation of the likes of Syme. Either way, it is much broader than the original “at the end of life (final weeks or months of life)”.

This leaves many questions unanswered: Does this call into question the judgement of the members of the Parliamentary Committee? Is it now considered that the Victorian public are open to this kind of extension where those who submitted to the Parliamentary Inquiry were clearly not? Will the members of the Parliamentary Committee rebuke the Panel for their extension?

Lack of answers aside, the idea of incremental extension is now out in the open for all to see. No Victorian MP can ignore it. They now need to question, not whether the model presented satisfies their judgement on a set of limits, but that their vote in support of any framework will most certainly provide precursory endorsement and impetus to later extension.

Dutch Health Minister, Edith Schippers, speaking enthusiastically about euthanasia recently, confirmed: "One thing is certain: on euthanasia and assisted suicide, we will never be finished."

The Panel's interim report is likely to be made public in the next few weeks.